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20
Somewhat tardily the Local Government Board issued a circular
letter authorizing local authorities, on the recommendation of their
medical officer of health, to expend a reasonable sum in retaining in
exceptional cases in their homes, persons who have been exposed to
infection. In my opinion this letter did not go far enough, because it
did not appear to recognise the present condition of things. This
letter states: "The Board, therefore, think it desirable to state that
they are advised that, under ordinary circumstances, the quarantining
at their homes of inmates of such dwellings is not necessary in
districts in which sanitary matters are properly administered and
vaccination and re-vaccination are efficiently carried out," again,
"If, on a dwelling becoming invaded by small-pox, the actual patients
are at once removed to hospital, the dwelling and all articles in it
that have been exposed to infection, including the clothes worn by
the other inmates, are properly disinfected, and the inmates of the
house are immediately re-vaccinated or vaccinated (as the case may
be) there is no material advantage to be gained by keeping these
other inmates at home." Now this letter assumes that vaccination
and re-vaccination can be enforced. Why the fact is that vaccination
cannot be efficiently carried out, because it is left to the guardians of
children to decide whether it shall be done; and re-vaccination being
a purely voluntary matter, it is almost unnecessary to say that
it cannot in the existing state of the law be efficiently carried
out.
There is another side of this question which should be mentioned.
Even though an inmate of an infected house might with safety go to
work, the employers in the majority of cases will not have him back,
until something like a fortnight to three weeks have elapsed.
In practice it was found that the best line of action in dealing
with contacts was to quarantine them at home, and allow them sufficient
each week to keep them from applying for parish relief, making
it a condition for receiving this assistance, that each member should
either be vaccinated, or as the case may be, re-vaccinated. This